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April 2016

An MT's Farewell Letter to the Industry
By Teresa Gravlin
For The Record
Vol. 28 No. 4 P. 26

Dear For The Record:

I am writing to you today to express my disappointment in the medical transcription industry and the HIM industry as a whole. I began as a medical transcriptionist (MT) in 1995 after receiving an HIM degree and finding my niche in transcription. I have worked as an independent contractor and as a full-time employee from home since 1997. When I started in transcription, I grossed $80,000 annually in income. This year, thanks to voice recognition, I did not make even $30,000. As you can see, this is a huge difference!

First came the outsourcing problems. I can tell you from experience that employers do not bother to inform their MTs that they are outsourcing their work. We wake up one day and there is just no work. I actually resigned from an MT position because my employer started outsourcing their work to the Philippines and after weeks of leaving us in the dark (until their backlog was caught up), they finally confessed what they were doing. We were told we would have to take a pay cut in order to stay employed. I found other employment. I rode out the storm of work being outsourced for years, trying to hang on to a job that I loved and did very well, working from home and doing transcription in different states.

Second came voice recognition, the industry's new technology that was going to save so much time and money for all involved. Yet, they forgot about the transcriptionist once again. I had to take a pay cut to exactly one-half of what I made per line transcribing manually. Doing so meant I had to do twice the amount of lines at half the pay to get what I normally made in a week transcribing manually.

I realize there are MTs and employers that believe voice recognition is faster and more productive. I can tell you it is not. Voice recognition has ruined my eyesight due to hours spent staring at a screen "following along" and correcting as I go. It requires massive amounts of concentration to stay focused on what you are hearing and seeing when listening and actually typing the words is, in my opinion, much faster and definitely more accurate. Do you know how many he/she, left/right, misunderstood drugs and dosages that I have to correct in a day? Does voice recognition know the ins and outs of the physicians like I do? Does voice recognition have the ability to realize when things just do not make sense? No. It cannot do any of these things. For the HIM industry to believe that a physician is going to take the time to ensure that all of these things are correct in a document before signing off is ridiculous.

I am confident that most doctors do not read their reports completely in the first place. I am also confident that an offshore transcriptionist is not going to understand the gist of what our non-English-speaking providers are saying—and neither will voice recognition. A "checklist" for a patient encounter is not going to accurately or completely describe that encounter or the patient's problem; this concept of documenting a medical visit is just wishful thinking.

Since the end of last year, I have watched my particular workload dwindle to nothing. I went from over 2,500 lines produced a day to fewer than 400. I cannot make a living like this. I woke up this morning to an e-mail telling me that since our contracted hospital/clinic decided to place all their physicians on Dragon [speech recognition software] and they will be reviewing/editing their own work, I am now out of a job in two weeks.

After 21 years in the business, I am now unemployed. I am looking at the MTStars website and there are MTs there with 20 and 30 years of experience looking for work and complaining about wage decreases and outsourcing, and expressing general dissatisfaction with the industry. I also just read a post where an MT was fined for missing an error that resulted in several hundred dollars lost from her pay. Did the physician get fined for dictating it wrong? Of course not. Where is their accountability?

While everyone is busy writing articles on ICD-10, health insurance, and outsourcing, voice recognition is killing the transcription industry, and no one seems to care. Where is the support for the American transcriptionists? Where is our fair wage? What is going to happen when the physicians fail to review their work and those reports end up in court? Who is going to explain to a patient's family or attorney why the physician cannot tell if a patient is a he or a she? Left or right? Pradaxa or Primaxin? These are things that I deal with every day in transcription. Without the MT, there is no accurate report.

In closing, I would like to say that I wish someone, anyone, would stand up for the American MT just once! The AAMT (American Association for Medical Transcription) did not help me find better employment; they just wanted money for unrealistic "conventions" in Hawaii and other places that most of us could not afford unless we were in management. Health information needs to take a step back and look at what they are doing to caring professionals who are good at what they do before it is too late. Sadly, for me, it already is. At 50 years old, I now have to find a different profession. I can guarantee you it will not be in transcription.

Teresa Gravlin
Marlette, Michigan